Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left foot pain, localized to the midfoot/hindfoot, exacerbated by weight-bearing activities and uneven terrain. History of progressive stiffness and recurrent ankle sprains. No history of acute trauma. Symptoms are consistent with congenital calcaneonavicular coalition.
Clinical Examination Findings
Left foot examination reveals a rigid flatfoot deformity with restricted subtalar joint motion. Tenderness noted over the calcaneonavicular joint interval. "Anteater nose" sign may be present on radiographic imaging. Gait analysis shows decreased hindfoot eversion/inversion during the stance phase.
Treatment Protocol
Initial management includes activity modification, orthotic arch support, and non-steroidal anti-inflammatory drugs (NSAIDs). If conservative measures fail, consider physical therapy for range of motion or surgical intervention (resection of the coalition with interposition of fat/muscle graft or arthrodesis).